Bench Staff Registration (Raiders Hockey Club)

ALLIANCE HOCKEY Digital Network

Bench Staff Registration

Team

Please select the team you are associated with and your position on that team staff.

Personal

Please enter your name, date of birth and complete address.

Communication

Please list the email addresses and phone numbers you wish to share. We must have 1 email address and 1 phone number for communication purposes. You control what we make public for privacy reasons so please indicate which information, if any, that you would like to display in your team profile. A COPY OF THIS FORM WILL BE SENT TO PRIMARY EMAIL 1 AS CONFIRMATION OF YOUR SUBMISSION

Certification

Please insert your current level of certification in each category if applicable. All team personnel must have PRS Certification.

Police Check

Valid Police Checks must have an issue date after January 1, 2017

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